Personality predictors of dementia diagnosis and neuropathological burden: An individual participant data meta-analysis

Alzheimers Dement. 2024 Mar;20(3):1497-1514. doi: 10.1002/alz.13523. Epub 2023 Nov 29.


Introduction: The extent to which the Big Five personality traits and subjective well-being (SWB) are discriminatory predictors of clinical manifestation of dementia versus dementia-related neuropathology is unclear.

Methods: Using data from eight independent studies (Ntotal = 44,531; Ndementia = 1703; baseline Mage = 49 to 81 years, 26 to 61% female; Mfollow-up range = 3.53 to 21.00 years), Bayesian multilevel models tested whether personality traits and SWB differentially predicted neuropsychological and neuropathological characteristics of dementia.

Results: Synthesized and individual study results indicate that high neuroticism and negative affect and low conscientiousness, extraversion, and positive affect were associated with increased risk of long-term dementia diagnosis. There were no consistent associations with neuropathology.

Discussion: This multistudy project provides robust, conceptually replicated and extended evidence that psychosocial factors are strong predictors of dementia diagnosis but not consistently associated with neuropathology at autopsy.

Highlights: N(+), C(-), E(-), PA(-), and NA(+) were associated with incident diagnosis. Results were consistent despite self-report versus clinical diagnosis of dementia. Psychological factors were not associated with neuropathology at autopsy. Individuals with higher conscientiousness and no diagnosis had less neuropathology. High C individuals may withstand neuropathology for longer before death.

Keywords: Braak stage; CERAD; Lewy body disease; TDP-43; agreeableness; arteriosclerosis; cerebral amyloid angiopathy; cerebral atherosclerosis; extraversion; gross cerebral infarcts; gross cerebral microinfarcts; hippocampal sclerosis; individual participant data meta-analysis; openness; positive affect; satisfaction with life.

Publication types

  • Meta-Analysis

MeSH terms

  • Aged
  • Aged, 80 and over
  • Autopsy
  • Bayes Theorem
  • Dementia* / diagnosis
  • Dementia* / pathology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neuropathology
  • Personality*